Healthcare

I’m suffering from Trump Fatigue. The disease hasn’t progressed to the point that I need to see my doctor, but as a precaution, I’m limiting the amount of time I watch or listen to the news. Say what you will, Mr. Trump has brilliantly manipulated the news cycle.

The Donald is larger than life: big, bold, brash. At the beginning, when he burst upon the scene, I was like, “Alright, finally a candidate who speaks plainly.” I’m of the opinion he moved the presidential discourse in a very healthy direction: build a wall, our leaders are stupid people, I’ll make America great again. But I’m tired of the platitudes. It’s like I’ve been drinking Coke Zero for a month and have a need for the real thing.

What are Mr. Trump’s core values? He says he can work with anyone, he’s the master of the deal, but where does he draw the line? Actually, who is he? Strip away veneer and what does he really believe? Listening to his answers I’m not sure, and becoming more confused each time I hear him speak.

First, he’s pro choice, very pro choice. Now he’s pro life, but is he very pro life. I understand people change their position, but why? Did he do so to become more palatable to Evangelicals? I wish I knew.

As an example, consider this dialogue with Scott Pelly on the topic of healthcare for the underprivileged.

“Donald Trump: Obamacare’s going to be repealed and replaced. Obamacare is a disaster if you look at what’s going on with premiums where they’re up 40, 50, 55 percent.

Scott Pelley: How do you fix it?

Donald Trump: There’s many different ways, by the way. Everybody’s got to be covered. This is an un-Republican thing for me to say because a lot of times they say, “No, no, the lower 25 percent that can’t afford private. But–

Scott Pelley: Universal health care.

Donald Trump: I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.

Scott Pelley: The uninsured person is going to be taken care of. How? How?

Donald Trump: They’re going to be taken care of. I would make a deal with existing hospitals to take care of people.”

There we go again, he “would make a deal”! In all fairness to Mr. Trump, later he goes on to say that the government would pay for the care. As a taxpayer, is that really what I want to hear? What is his presidential candidacy, the game show Let’s Make a Deal?

Instead of Let’s Make a Deal, maybe we should play game show To Tell the Truth and ask, “will the real Donald Trump to please stand up.”

I am curious as to the outcome of the Iowa Caucus. Are empty phrases and brashness enough to sway the outcome in his favor, or are a majority of Iowan’s, like me, looking for some substance?

It is no secret that ObamaCare – President Barack Obama’s “doomed to fail” government run health care scheme – is an expensive bureaucratic behemoth that spends more on paperwork, top-down control and IRS enforcement than it spends on healthcare itself.

So much so that 87% of Obamacare enrollees need federal aid to pay their premiums according to the Department of Health and Human Services – more than planned for through the annual appropriations of Congress suggests House Ways and Means Chairman Rep. Paul Ryan, (R- WI).

So how did the lawless Obama Administration make up the shortfall? Rep. Paul suspects the U.S. Treasury Department was ordered – in violation of federal law – to pay out more than $3 billion to health insurers even though Congress did not authorize the spending.

According to a letter Rep. Paul sent to Treasury Secretary Jacob Lew, Paul explained how the Committee on Ways and Means is responsible, in part, with conducting oversight into the implementation of the Patient Protection and Affordable Care Act (“PPACA” a.k.a. ObamaCare) and the implementation of the PPACA’s cost-sharing (premium subsidy) reduction program.

Paul pointedly states:

“Congress has never appropriated any funds to permit the administration to make any”. . . “payments to insurance companies.” Despite lacking an appropriation, Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner informed the (committee) in December 2014 that insurers ”have been paid a cumulative total of $2.7 billion in advance”. . .”payments through the November 2014 payment cycle.”

Taking Treasury Secretary Lew to task, Rep. Paul explained:

“Article I of the U.S. Constitution expressly prohibits the expenditure of public funds without an appropriation made by law. Accordingly, it appears that the Department of Health and Human Services (“HHS”) has directed the Treasury Department to make payments to insurers”…”even though no funds are lawfully available to do so.”

Philip Klein writing for The Washington Examiner writes that the issue is turns on “payments to insurers known as cost-sharing subsidies”…”because President Obama’s healthcare law forces insurers to limit out-of-pocket costs”… and “capping consumer expenses, such as deductibles and co-payments, in insurance policies. In exchange for capping these charges, insurers are supposed to receive compensation.”

House Speaker John Boehner believed that the appropriations issue was of such importance in law and principal that he included unauthorized cost-sharing payments in his lawsuit against the Obama administration’s executive actions and overreach on Obamacare.

In response to Rep. Ryan’s inquiry, the Treasury Department sent a letter describing the program while avoiding a detailed explanation of how and under whose authority Treasury decided to make cost-sharing payments.

The letter was remarkable in this respect.

According to the letter, “$2.997 billion in such payments had been made in 2014” – more than the $2.7 billion originally believed. The letter directed Rep. Ryan to the Department of Justice for further explanation.

When Department of Veterans Affairs (VA) physician Dr. Katherine Mitchell filed a confidential complaint in September 2013 with the office of Arizona Sen. John McCain about the wait time’s veterans were experiencing at a Phoenix VA hospital, little did she know what would happen next.

Her “confidential” complaint was routed in error to the VA’s Inspector General’s office that immediately placed her on administrative leave pending an investigation.

Her complaint?

Someone in Phoenix was cooking the books to make wait times for veterans needing doctor appointments seem far less than they really were – all in order to create the fiction that veterans were getting appointment times within the two to four-week period called for in VA guidelines.

Schedulers within the Phoenix VA Health Care System were keeping two sets of records to conceal prolonged patient waits for appointments and treatment. One set showed the real wait times that veterans were experiencing (four months or more) and one for auditors that showed three to four weeks – a sharp decrease in wait times for care.

It seems that once a doctor’s visit could be scheduled inside the “two to four-week window”, veterans were moved from the real wait list to the phony wait list to improve the wait time numbers. As a reward, VA employees were given cash bonuses and other benefits from VA administrators.

An examination of an e-mail exchange among employees at the Carl T. Hayden VA Medical Center in Phoenix had program analyst Damian Reese complaining that administrators were cheering their “Wildly Important Goals” program as a success because it showed a dramatic reduction in wait times for patient appointments.

According to Reese:

“I think it’s unfair to call any of this a success when veterans are waiting six weeks on an electronic waiting list before they’re called to schedule their first PCP (primary-care provider) appointment,” “Sure, when their appointment was created, (it) can be 14 days out, but we’re making them wait 6-20 weeks to create that appointment. That is unethical and a disservice to our veterans.”

One whistleblower alleged that at least 40 veterans died while waiting for care on the secret list. The investigation final report showed that of the 93 VA facilities reviewed, three fourths had engaged in the deceptive scheduling to improve wait time statistics in order to receive cash bonuses.

The VA has cancelled the cash bonus incentive program – or has it.

In a piece for January 12 issue of The Washington Times, Jacqueline Klimas reports that:

“The Philadelphia VA announced a new incentive program earlier this month that rewards employees with cash and food for deciding cases quickly — a move that some employees say will encourage staff to rush claims and reject deserving applicants, once again leaving veterans struggling for benefits.”

Two days later, Klimas updated her report. According to Klimas:

“The Philadelphia VA regional office abruptly canceled plans Wednesday to pay bonuses for speeding up claims processing, after employees said they feared the bonuses would encourage them to make hasty decisions and deny deserving veterans their rightful benefits. The bonus program…offered $15,000 bonuses to teams that met processing targets and offered breakfast, lunch or snacks to teams that processed the most claims.”

Ms. Diana Rubens, director of the Veterans Affairs regional office in Philadelphia, wrote employees on Wednesday that the program was “rescinded, effective immediately.”

Though it violates both state and federal law, Massachusetts spent tens of millions of dollars to give illegal immigrants medical care—including prescription drugs, physical therapy and dental services—through its taxpayer-funded healthcare program for low-income individuals.

Tax-paying residents of the Bay State should be outraged, to say the least. The information comes straight out of a scathing report that contains the findings of an investigation conducted by Massachusetts State Auditor Suzanne Bump. It reveals that questionable or prohibited medical claims totaling $35,137,347 were reimbursed by the state’s Medicaid agency known as MassHealth. A chunk of it went to non-emergency services for illegal immigrants, according to the audit.

MassHealth costs are divided between the state and federal government to provide healthcare for the poor. Established regulations at both the federal and state level specifically forbid undocumented immigrants from receiving coverage for non-emergency treatment in government-funded Medicaid programs nationwide. Each year MassHealth doles out more than $10.8 billion so that 1.4 million eligible people—legal residents—who can’t afford medical treatment can access it. Of the more than $35 million that funded treatment for illegal aliens, $27.8 million went to inpatient and outpatient services, the probe found. The rest was spent on prescription drugs ($3.6 million), dental services ($1.7 million) and rehabilitation and physical therapy ($1.9 million).

The investigation covers a small period that runs from July 2011 to December 2012 so it only represents a snippet of the actual waste and violations. Evidently MassHealth officials know exactly what they’re doing and hide behind their own interpretation of federal and state rules, according to Bump, the state auditor. “In the course of the audit we saw that MassHealth regularly substituted its own judgment for that of the medical professional in determining whether to cover a service,” Bump said in a statement announcing her findings. “Based on our understanding of the plain language in the regulations, MassHealth Limited is paying for ineligible services, and the tab is costly.”

American taxpayers have long been stuck with the exorbitant cost of providing illegal immigrants with medical care. In fact, Judicial Watch has been reporting it for years, citing figures provided by state, federal and county governments. Besides spending billions of dollars annually as a nation to medically treat illegal aliens, here are a couple of exceptional cases reported by JW over the years; California, the state with the nation’s largest illegal immigrant population offers the demographic free organ transplants and the costly follow-up treatment required after the complicated surgery. In Scott County Minnesota the public paid for an incarcerated illegal alien’s $50,000 penis pump because it was billed as an “emergency” medical procedure. The list goes on and on.

The problem has gotten so out of control that a few years ago a Democratic congressman from Ohio introduced legislation requiring foreign countries to reimburse American taxpayers for the exorbitant medical expenses of illegal immigrants. The measure, known as the PAYBACK Act (Preventing All Your Bucks from Aiding non-Citizens is Key) was estimated to save the U.S. government billions annually and ensure that public funds were not used to finance healthcare services for illegal immigrants. The bill was referred to the House Subcommittee on Border, Maritime and Global Counterterrorism for consideration but didn’t get very far after that.